Project Summary. Compared to heterosexual women, sexual minority women (e.g., lesbian and bisexual women) face heightened risk for sexual and reproductive health (SRH) disparities. Though this seems counterintuitive, many sexual minority women have sexual histories with men which place them at risk for outcomes like teenage pregnancy. Research has shown that sexual minority women are also less likely to use contraceptive methods including barrier-based protection that can prevent sexually transmitted infections (STIs), and they have higher rates of STI contraction than heterosexual women. To date, the health communication mechanisms that contribute to these disparities are not well understood. Wider literature on general female populations points to sexual health information, patient-provider communication, and maternal communication as important predictors of SRH in adolescent and adult female samples. However, exploratory descriptive work on the health information and communication experiences of sexual minority women point to themes of difficulty accessing appropriate information, negative or uninformative encounters with providers, and hesitation from mothers about discussing SRH with sexual minority girls. Thus, the goal of this project is to examine how sexual health information, patient-provider communication, and maternal SRH communication differ by sexual orientation and mediate SRH disparities in a sample of women from across the United States. These data, which are derived from three ongoing cohort studies of adolescent health, provide a unique opportunity to examine detailed measures of sexual orientation, health communication, and SRH histories of a large population-based sample of U.S. women. These research goals will be facilitated by the applicant?s training plan, which involves advancement in skillsets of biostatistics, epidemiology, and health communication research methods. Combined with a collaboration team of experts in the disciplines of social epidemiology, sexual minority health, biostatistics, and health communication, all of whom are hosted within the Boston Children?s Hospital network, this fellowship will provide an exceptional training environment and mentorship experience in these subject areas and contribute greatly to the success of this research plan. Findings from this project will be innovative in their ability to address communication facilitators and barriers of SRH in sexual minority women, a population that has been understudied in the wider SRH and health communication literature base. Findings will also be significant in their translation to both the sexual health information and communication practices of medical providers and other sources of health information (like maternal SRH communication). Ultimately, this NRSA addresses an important and vulnerable health area for sexual minority women, a group recently recognized by the NIH as a health disparity population.